title: "Carcinoid-like" tricuspid valvulopathy associated with nephrogenic systemic fibrosis.
abstract: We present a case of a patient with end-stage renal disease and nephrogenic fibrosing dermopathy (NFD) whose echocardiogram demonstrated rare tricuspid valve abnormality with malcoaptation due to tethering and restricted motion of the leaflets causing severe tricuspid regurgitation. The cardiac abnormalities developed 3 years after her initial diagnosis of NFD was made by skin biopsy. The echocardiographic appearance of the tricuspid valve resembled that seen in patients with carcinoid heart disease; however, an evaluation for carcinoid tumor in our patient was negative. Myocardial biopsy performed at the time of right heart catheterization demonstrated trace gadolinium within the lysosomes of one cardiac fibroblast. This report is the first to describe the association between nephrogenic systemic fibrosis and severe valvular heart disease requiring valve replacement.
authors.affiliation: Division of Cardiology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: S Michael
authors.initials: SM
authors.lastname: Gharacholou
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Maleszewski
authors.forename: Barry A
authors.initials: BA
authors.lastname: Borlaug
authors.forename: Fernando G
authors.initials: FG
authors.lastname: Cosio
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Dearani
authors.forename: Sudhir S
authors.initials: SS
authors.lastname: Kushwaha
authors.forename: Naser M
authors.initials: NM
authors.lastname: Ammash
mesh_terms: D000328:Adult; D002275:Carcinoid Heart Disease / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D054989:Nephrogenic Fibrosing Dermopathy / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography / Q000379:methods*